CMS Issues Outpatient Hospital Prospective Payment System Rule

The Centers for Medicare and Medicaid Services (CMS) issued a proposed rule today that would update payment policies and payment rates for services furnished to Medicare beneficiaries in hospital outpatient departments (HOPDs) and ambulatory surgical centers (ASCs) beginning January 1, 2013. CMS projects that total payments to hospitals under the Outpatient Prospective Payment System (OPPS) in calendar year 2013 will be approximately $48.1 billion.

The OPPS proposed rule includes several proposals that would affect the Inpatient Rehabilitation Facility (IRF) Quality Reporting Program. Specifically, the proposed rule would allow updates to the IRF quality reporting program measures based on changes that occur during recognized measure endorsement processes. All IRF quality measures will remain in effect until the measure is actively removed, suspended, or replaced.

APTA will submit comments in response to the proposed rule by the September 4 public comment deadline. CMS will respond to all comments in a final rule to be issued by November 1.